男孩，14岁体检时，89磅，148CM， 儿科医生推荐看pediatric endocrinologist, 做了X-ray和抽血 下面时结果 Xray indication: delayed puberty, short status Findings: the patient is a male with a chronologic age of 14 years and 5 month. Based on the standards of Greulich and Pyle, the patient's bone age is 14 years, with a standard deviation of 10.72 months. Impression: Normal bone age within 2 standard deviations of chronologic age, Inhibin B pg/ml 170.7 IGF-1/Somatomedin-C ng/ml 154 IGF Binding protein 3-combo ug/ml 3361 Ultra sensitive lh(send out) - combo mIU/ml 3.2 FSH, Utra Sensitive mIU/ml 7.1 Testosterone Total LC/MS ng/ml 69 说他生长素可能偏低，要做一个生长激素测试，约了2个月后，下面是结果 Growth Hormone ng/ml, 第一轮 Tube 1 - 0.08, Tube 2 - 0.26, Tube 3 - 0.23, Tube 4 - 9.35, Tube 5 - 8.11；第二轮 Tube 1 - 0.64, Tube 2 - 0.62, Tube 3 - 3.09, Tube 4 - 3.80, Tube 5 - 4.42， 第二轮中间连续喷嚏，医生怀疑他药物过敏，停啦两个多小时，然后再继续 ACTH-Combo pg/ml 16.7 Control AM-Combo mcg/ml 9.0 Free Thyroxine (Free T4) ng/ml 1.00 Testosterone, Pediatric (total) - Combo ng/ml 90 Thyroid Stimulat Horm - Combo uIU/ml 1.71 FSH, Utrasensitive - Combo mIU/ml 8.6 Ultra sensitive LH(send out) - Combo mIU/ml 2.4 最后的诊断是生长素偏低，但是也还算正常，他们跟保险公司联系过，可以开始生长素治疗。可是我们就犹豫啦。他爸说，他14岁时身高大概差不多。他高考体检，身高也就166，考研体检身高172， 爷爷身高跟爸爸差不多。奶奶身高大概在157左右。我是163，姥姥160， 姥爷172左右. 最后我们决定再观察一段，但是医生警告说， 这个可以治疗的window时很短的，到16岁就很可能晚啦。 回访过两次，都是做啦X-ray， 结果 第一次 Finding: The patient is a male with a chronologic age of 14 years and 11 months. Based on the standards of Greulich and Pyle, the patient's bone age is 13 yeas, with a standard deviation of 11 months 第二次 Comparison: the last Xray where the patient's chronologic age was 14 years 11 months and the patient's bone age was 13 years Finding: The patient is a male with a chronologic age of 15 years and 6 months. Based on the standard of Greulich and Pyle, the patient's bone age is still 13 years, with a standard deviation of 11.32 months. Keep in mind the sesamoid has not even developed at the thumb. Rest of the appearance of the epiphyses is more closer to 13 years. Impression: Delayed bone age more than 2 standard deviations below chronologic age. 现在是95磅，157CM social worker也来访问，调查他在学校里，家里愉快不愉快呀？ pediatric psychologist 也来约，问他觉得个子矮，有没有压力呀？本来他是无大所谓的， 现在也弄的有点紧张。我们家长也挺大压力的
Inhibin B pg/ml 170.7 IGF-1/Somatomedin-C ng/ml 154 IGF Binding protein 3-combo ug/ml 3361 Ultra sensitive lh(send out) - combo mIU/ml 3.2 FSH, Utra Sensitive mIU/ml 7.1 Testosterone Total LC/MS ng/ml 69
说他生长素可能偏低，要做一个生长激素测试，约了2个月后，下面是结果 Growth Hormone ng/ml, 第一轮 Tube 1 - 0.08, Tube 2 - 0.26, Tube 3 - 0.23, Tube 4 - 9.35, Tube 5 - 8.11；第二轮 Tube 1 - 0.64, Tube 2 - 0.62, Tube 3 - 3.09, Tube 4 - 3.80, Tube 5 - 4.42， 第二轮中间连续喷嚏，医生怀疑他药物过敏，停啦两个多小时，然后再继续
ACTH-Combo pg/ml 16.7 Control AM-Combo mcg/ml 9.0 Free Thyroxine (Free T4) ng/ml 1.00 Testosterone, Pediatric (total) - Combo ng/ml 90 Thyroid Stimulat Horm - Combo uIU/ml 1.71 FSH, Utrasensitive - Combo mIU/ml 8.6 Ultra sensitive LH(send out) - Combo mIU/ml 2.4
最后的诊断是生长素偏低，但是也还算正常，他们跟保险公司联系过，可以开始生长素治疗。可是我们就犹豫啦。他爸说，他14岁时身高大概差不多。他高考体检，身高也就166，考研体检身高172， 爷爷身高跟爸爸差不多。奶奶身高大概在157左右。我是163，姥姥160， 姥爷172左右.
最后我们决定再观察一段，但是医生警告说， 这个可以治疗的window时很短的，到16岁就很可能晚啦。
回访过两次，都是做啦X-ray， 结果 第一次 Finding: The patient is a male with a chronologic age of 14 years and 11 months. Based on the standards of Greulich and Pyle, the patient's bone age is 13 yeas, with a standard deviation of 11 months 第二次 Comparison: the last Xray where the patient's chronologic age was 14 years 11 months and the patient's bone age was 13 years Finding: The patient is a male with a chronologic age of 15 years and 6 months. Based on the standard of Greulich and Pyle, the patient's bone age is still 13 years, with a standard deviation of 11.32 months. Keep in mind the sesamoid has not even developed at the thumb. Rest of the appearance of the epiphyses is more closer to 13 years. Impression: Delayed bone age more than 2 standard deviations below chronologic age.
现在是95磅，157CM social worker也来访问，调查他在学校里，家里愉快不愉快呀？ pediatric psychologist 也来约，问他觉得个子矮，有没有压力呀？本来他是无大所谓的， 现在也弄的有点紧张。我们家长也挺大压力的
另外，为啥十四岁半时候测出骨龄14，一年后15岁半骨龄反而只有13，医生有啥说法吗
有的男孩儿高中才开始长个儿，如楼上所说，社工还管这？？？
医生说 这个骨龄是个统计学上的概念，有一定的误差，每个读片子的人看法稍有差别 她个人看了我家儿子的片子，她倾向认为更靠近13岁。
儿童医院里的social worker，应该是从医生哪知道的
按生长表11-12岁男孩一米四几是正常的